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dc.contributor.authorGuerin, P J
dc.contributor.authorBrasher, C
dc.contributor.authorBaron, E
dc.contributor.authorMic, D
dc.contributor.authorGrimont, F
dc.contributor.authorRyan, M
dc.contributor.authorAavitsland, P
dc.contributor.authorLegros, D
dc.date.accessioned2008-01-31T14:52:53Z
dc.date.available2008-01-31T14:52:53Z
dc.date.issued2004-11
dc.identifier.citationCase management of a multidrug-resistant Shigella dysenteriae serotype 1 outbreak in a crisis context in Sierra Leone, 1999-2000. 2004, 98 (11):635-43 Trans. R. Soc. Trop. Med. Hyg.en
dc.identifier.issn0035-9203
dc.identifier.pmid15363643
dc.identifier.doi10.1016/j.trstmh.2004.01.005
dc.identifier.urihttp://hdl.handle.net/10144/17254
dc.description.abstractFrom December 1999 to the end of February 2000, 4218 cases of dysentery were reported in Kenema district, southeastern Sierra Leone, by a Médecins Sans Frontières team operating in this region. Shigella dysenteriae serotype 1 was isolated from the early cases. The overall attack rate was 7.5% but higher among children under 5 years (11.2%) compared to the rest of the population (6.8%) (RR = 1.6; 95% CI 1.5-1.8). The case fatality ratio was 3.1%, and higher for children under 5 years (6.1% vs. 2.1%) (RR = 2.9; 95% CI 2.1-4.1). A case management strategy based on stratification of affected cases was chosen in this resource-poor setting. Patients considered at higher risk of death were treated with a 5 day ciprofloxacin regimen in isolation centres. Five hundred and eighty-three cases were treated with a case fatality ratio of 0.9%. Patients who did not have signs of severity when seen by health workers were given hygiene advice and oral rehydration salts. This strategy was effective in this complex emergency.
dc.language.isoenen
dc.publisherElsevier
dc.relation.urlhttp://www.sciencedirect.com/science/journal/00359203
dc.rightsArchived on this site with the kind permission of Elsevier Ltd. and the Royal Society of Tropical Medicine and Hygiene, http://www.rstmh.org/transactions.aspen
dc.subject.meshAdolescenten
dc.subject.meshAdulten
dc.subject.meshAge Distributionen
dc.subject.meshAgeden
dc.subject.meshAged, 80 and overen
dc.subject.meshAnimalsen
dc.subject.meshAnti-Infective Agentsen
dc.subject.meshChilden
dc.subject.meshChild, Preschoolen
dc.subject.meshCiprofloxacinen
dc.subject.meshDisease Outbreaksen
dc.subject.meshDrug Resistanceen
dc.subject.meshDysentery, Bacillaryen
dc.subject.meshFemaleen
dc.subject.meshHumansen
dc.subject.meshMaleen
dc.subject.meshMiddle Ageden
dc.subject.meshSerotypingen
dc.subject.meshSex Distributionen
dc.subject.meshShigella dysenteriaeen
dc.subject.meshSierra Leoneen
dc.titleCase management of a multidrug-resistant Shigella dysenteriae serotype 1 outbreak in a crisis context in Sierra Leone, 1999-2000.en
dc.contributor.departmentEpicentre, 8 rue Saint Sabin, 75011 Paris, France. philippe.guerin@epicentre.msf.orgen
dc.identifier.journalTransactions of the Royal Society of Tropical Medicine and Hygieneen
refterms.dateFOA2019-03-04T09:01:07Z
html.description.abstractFrom December 1999 to the end of February 2000, 4218 cases of dysentery were reported in Kenema district, southeastern Sierra Leone, by a Médecins Sans Frontières team operating in this region. Shigella dysenteriae serotype 1 was isolated from the early cases. The overall attack rate was 7.5% but higher among children under 5 years (11.2%) compared to the rest of the population (6.8%) (RR = 1.6; 95% CI 1.5-1.8). The case fatality ratio was 3.1%, and higher for children under 5 years (6.1% vs. 2.1%) (RR = 2.9; 95% CI 2.1-4.1). A case management strategy based on stratification of affected cases was chosen in this resource-poor setting. Patients considered at higher risk of death were treated with a 5 day ciprofloxacin regimen in isolation centres. Five hundred and eighty-three cases were treated with a case fatality ratio of 0.9%. Patients who did not have signs of severity when seen by health workers were given hygiene advice and oral rehydration salts. This strategy was effective in this complex emergency.


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